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关节镜下孤立性II型SLAP损伤修复术后功能进展及疼痛缓解作为恢复运动指标的前瞻性研究

Progression of function and pain relief as indicators for returning to sports after arthroscopic isolated type II SLAP repair-a prospective study.

作者信息

Boesmueller Sandra, Tiefenboeck Thomas M, Hofbauer Marcus, Bukaty Adam, Oberleitner Gerhard, Huf Wolfgang, Fialka Christian

机构信息

AUVA Trauma Center Vienna Meidling, Kundratstraße 37, 1120, Vienna, Austria.

Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

出版信息

BMC Musculoskelet Disord. 2017 Jun 13;18(1):257. doi: 10.1186/s12891-017-1620-3.

Abstract

BACKGROUND

One of the currently used surgical techniques in isolated type II SLAP lesions is arthroscopic SLAP repair. Postoperatively, patients tend to suffer from a prolonged period of pain and are restricted in their sports activities for at least 6 months. The aim of this study was to prospectively evaluate the clinical outcome as well as the postoperative course of pain after arthroscopic type II SLAP repair.

METHODS

Outcome measures were assessed using the Individual Relative Constant Score (CS), the American Shoulder and Elbow Surgeons (ASES) Score, the Visual Analogue Scale (VAS), and the Short Form 36 (SF-36). Data were collected preoperatively, as well as at 3, 6, 12 and >24 months postoperatively.

RESULTS

Eleven patients with an average age of 31.8 years (range: 22.8-49.8 years) underwent arthroscopic repair of isolated type II SLAP lesions. Mean follow-up time was 41.9 months (range: 36.1-48.4 months). 6 months after surgery, there was a statistically significant improvement of function according to the CS (p = 0.004), the ASES Score (p = 0.006), and the SF-36 subscale "physical functioning" (p = 0.014) and a statistically significant decrease of pain according to the VAS (p = 0.007) and the SF-36 subscale "bodily pain" (p = 0.022) compared to preoperative levels.

CONCLUSIONS

Arthroscopic repair of isolated type II SLAP lesions with suture anchors leads to a satisfactory functional outcome and return to pre-injury sports levels, with delayed, but significant pain relief observed 6 months after surgery. Thus, a return to sports should not be allowed earlier than 6 months after surgery, when patients have reached pain-free function and recovered strength.

TRIAL REGISTRATION

Researchregistry1761 (UIN).

摘要

背景

关节镜下SLAP修复是目前用于孤立性II型SLAP损伤的手术技术之一。术后,患者往往会经历较长时间的疼痛,并且至少6个月内其体育活动受到限制。本研究的目的是前瞻性评估关节镜下II型SLAP修复后的临床结果以及术后疼痛过程。

方法

使用个体相对常数评分(CS)、美国肩肘外科医师(ASES)评分、视觉模拟量表(VAS)和简短健康调查问卷36项版本(SF-36)评估结果指标。在术前以及术后3、6、12和>24个月收集数据。

结果

11例平均年龄为31.8岁(范围:22.8 - 49.8岁)的患者接受了孤立性II型SLAP损伤的关节镜修复。平均随访时间为41.9个月(范围:36.1 - 48.4个月)。与术前水平相比,术后6个月,根据CS(p = .004)、ASES评分(p = .006)和SF-36子量表“身体功能”(p = .014),功能有统计学意义的改善,根据VAS(p = .007)和SF-36子量表“身体疼痛”(p = .022),疼痛有统计学意义的减轻。

结论

使用缝合锚钉对孤立性II型SLAP损伤进行关节镜修复可带来令人满意的功能结果,并恢复到受伤前的运动水平,术后6个月观察到疼痛缓解延迟但显著。因此,在患者达到无痛功能并恢复力量之前,术后6个月内不应允许其恢复运动。

试验注册

Researchregistry1761(UIN)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c9/5470215/c0949b2853f6/12891_2017_1620_Fig1_HTML.jpg

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